Provider Demographics
NPI:1295007821
Name:TRAMPE, KEVIN C (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:C
Last Name:TRAMPE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1011 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:EDGERTON
Mailing Address - State:WI
Mailing Address - Zip Code:53534-1325
Mailing Address - Country:US
Mailing Address - Phone:608-884-3308
Mailing Address - Fax:608-884-7725
Practice Address - Street 1:1011 N MAIN ST
Practice Address - Street 2:
Practice Address - City:EDGERTON
Practice Address - State:WI
Practice Address - Zip Code:53534-1325
Practice Address - Country:US
Practice Address - Phone:608-884-3308
Practice Address - Fax:608-884-7725
Is Sole Proprietor?:No
Enumeration Date:2012-01-27
Last Update Date:2020-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI15925-040183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist